The role of asymmetric thickening of the uterine myometrium during pregnancy
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MATERNAL-FETAL MEDICINE
The role of asymmetric thickening of the uterine myometrium during pregnancy Yuji Shiina • Tsuyoshi Ohnuki
Received: 9 June 2012 / Accepted: 12 November 2012 / Published online: 27 November 2012 Ó Springer-Verlag Berlin Heidelberg 2012
Abstract Purpose This study aimed to examine the role of local uterine contractions during pregnancy depicted as asymmetric thickening of the myometrium ultrasonographically. Methods 419 pregnant women at 12–21 weeks of gestation who visited our outpatient department were studied. These subjects visited either for regular antenatal examinations or because of ill-defined subjective symptoms. Ultrasonographic examination was conducted to detect asymmetric thickening of the uterine myometrium. Blood flow in the region of myometrial thickening was studied by color Doppler imaging. Results Among 419 subjects, 27.38 % (112/419) patients visited our outpatient department showed asymmetric thickening of myometrium. Since cervical changes or progression to labor occurred in none of the subjects, the reviewed symptoms were considered to be benign contractions. Many women with ill-defined symptoms showed asymmetric thickenings of the myometrium (73.75 % sensitivity and 84.32 % specificity). Myometrial thickening under the placenta tended to be associated with abundant blood flow (88.46 % sensitivity and 87.21 % specificity). This different pattern of the blood flow was considered to correlate to arcuate artery resistance but did not correlate to the severity of ill-defined symptoms. Among those patients having no clinical symptoms, 53 exhibited asymmetric Y. Shiina (&) T. Ohnuki Department of Obstetrics and Gynecology, Yamagata Prefectural Shinjo Hospital, 12-55 Wakabacho, Shinjo, Yamagata 996-0025, Japan e-mail: [email protected] T. Ohnuki Department of Obstetrics and Gynecology, Yamagata Saisei Hospital, Yamagata, Japan
thickening of the myometrium. This phenomenon might be the caution of ill-defined symptoms. Conclusion Asymmetric thickening of the uterine myometrium during pregnancy represented the ill-defined symptoms. Different patterns of blood flow images at this local contraction did not correlate to the severity of these symptoms. Keywords Asymmetric thickening of the uterine myometrium Local uterine contraction Ill-defined symptom Ultrasonographic diagnosis
Introduction The inherent contractility of the uterus has been investigated by many researchers. Togashi et al. [1] reported two patterns of contraction. One is focal and sporadic bulging of the myometrium. The other is rhythmic and subtle stripping movement in the subendometrial myometrium, known as peristalsis. Peristalsis is related to important uterine functions such as fertility and menstrual problems, but the role of the bulging is still under debate. Togashi [2] also reported transient and mobile myometrial bulging of the uterus during pregnancy. Sustained uterine contractions partially force the blood out of the uterus and the decrease in blood volume results in the decease in water
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